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Hamid Moghaddasi, Farkhondeh Asadi, Azamossadat Hosseini, Masoomeh Nouri Tahneh,
Volume 17, Issue 4 (10-2023)
Abstract

Background and Aim: The Hospital Information System is a complete one to provide high-quality patient care and enhance community health, so it must be designed and produced accordingly. In this regard, the current research was carried out with the aim of providing the document of standards for producing Hospital Information System software for Iran. 
Materials and Methods: In this study, following extraction of the features and services of the Hospital Information System from the texts, they were matched with the generalities of the document of standards compiled by the Statistical Data Management and Information Technology Office of the Ministry of Health, Treatment, and Medical Education (SDMITO). Also, the Hospital Information System was reviewed observationally, all defects of document of standards were identified, and the document was amended throughout. After providing the proposed document of standards, it was consulted by a group of experts, which included ten health information management professors, ten medical informatics professors (with at least seven years of experience as members of the academic staff), and five heads of the information technology field of the Ministry of Health. An agreement coefficient of 85% was considered to accept and approve the document of standards. After obtaining the agreement coefficient, The Hospital Information System software production document of standards was provided.
Results: The document of standards provided for the production of Hospital Information System software includes the Hospital Information System design meta model, Hospital Information System subtypes, standards for the structure and content of Electronic Health Record, information terminology standards, data classification standards, security data standards, data exchange standards, clinical services, and management services, which were placed in the four areas of “features”, “services”, “documentation requirements” and “rules and policies”.                     
Conclusion: The application of this document of standards leads to the production of a higher quality, efficient, and standard Hospital Information System software, which is effective in improving the health level of society and provides the conditions for the implementation of Electronic Health Record.

Alireza Hajizadeh, Reza Hafezi, Mrs Maryam Tajvar,
Volume 17, Issue 5 (12-2023)
Abstract

Background and Aim: Futures studies are constantly evolving and help organizations and individuals for better identification of future events, opportunities, and threats. In the field of health, futures studies are also applied for better prediction of health issues in future, control of unpleasant condition and preparing for pleasant future in health system. The purpose of this study is to conduct a scoping review of the futures studies accomplished in the field of health in Iran, 
Materials and Methods: This study is a scoping review, conducted based on the Arksey and O’Malley framework with 6 steps including research question identification, related study identification, study selection / screening, data segmentation, summarizing and reporting results and providing guidance and recommendations n. National and international databases and search engines including PubMed, Web Of Science (WOS), Scopus, ProQuest, SID, Magiran, IranDoc and Google Scholar were searched using related keywords. After removing duplicate articles, the remaining articles were screened according to inclusion and exclusion criteria. The results of the selected articles were finally categorized, summarized and reported based on the mentioned steps.
Results: Among of 6691 articles identified, 30 articles reached the final synthesis stage. The articles were classified into forecasting, foresighting, and mixed categories, with the scenario writing method being the most widely used and applied in 20 studies. Also, studies were classified in scope of nature based on quantitative or qualitative and time horizon. Types of futures studies methods in Iran, in the fields of public health, medicine, science and technology, financing, prescription, health tourism, diet, human resources, aging, Covid-19 epidemic, health policy, hospital and macro level of health system were used.
Conclusion: The use of futures studies methods in a targeted manner and on the issues of Iran’s health system can play an effective role in knowing the future for more informed decision-making and planning in order to build a desirable future. The results of this review showed that scattered studies have been conducted with futures studies methods in the field of health, among which the scenario writing method has received more attention.


Zahra Khaje, Kamran Yazdani, Ibrahim Abdollahpour, Mohsen Mohammadi, Saharnaz Nedjat,
Volume 17, Issue 5 (12-2023)
Abstract

Background and Aim: Alzheimer’s is a chronic disease that causes cognitive disabilities, thinking, personality changes and disruptions in daily activities. Due to these disorders, patients need long-term care. Most care for Alzheimer’s patients is done at home by family members, which makes home caregivers mentally, physically, emotionally, socially and financially vulnerable. Health personnel have a key role to play in providing information and guidance and helping the family control these conditions. The purpose of this study was to examines the level of knowledge and attitude of health workers and determines the related factors. 
Materials and Methods: This research is a cross-sectional study to evaluate the level of knowledge and attitude of health workers about Alzheimer’s disease and its related factors. All 260 health workers of Gorgan and Kordkuy districts were studied by census method to assess their knowledge and attitude about Alzheimer’s disease and its related factors. ANOVA and T-tests were used to determine the relationship between the independent variables and the dependent variable. Variables whose significant level of correlation with response variable was less than 0.2 in bivariate analysis were entered into the regression model and finally multiple linear regression was used to determine the factors related to level of knowledge and attitude.
Results: The mean level of knowledge was 46.73% (95% CI, 45.46 to 48.16) and the mean level of attitude was 55.61% (95% CI, 54.63 to 56.74). The results show that those with a history of previous education, a history of caring for Alzheimer’s patients, a higher level of work experience in the health care system, and having a female gender and be married have higher levels of knowledge and those with a history of previous education and Sistani descent had a higher attitude.
Conclusion: In general, the mean level of knowledge was 46.73(0-100) and the mean level of attitude was 55.61(0-100). Factors such as: gender, work history in the health system, history of participating in educational workshops, history of caring for sick patients, and marital status were related to the level of knowledge and factors such as ethnicity and history of participating in the training workshop were related to the level of attitude of the health care providers.
Saeed Barzegari, Marjan Ghazi Saeedi, Roghieh Nazari, Seif Ali Mahdavi, Seyed Alireza Hasani,
Volume 17, Issue 5 (12-2023)
Abstract

Background and Aim: The use of Mobile-Health is helpful in facilitating therapeutic communication between students and healthcare providers. Considering the benefits of the Mobile-Health, it is very important to have a tool that can check the motivation to use Mobile-Health. Therefore, this study was conducted with the aim of Psychometric properties of mHealth Technology Engagement Index.
Materials and Methods: The present study is psychometric research that was conducted in Tehran University of Medical Sciences in 1401. The participants of this study were 450 students of medical sciences in Tehran in undergraduate, master’s and doctorate levels who were included in the study through convenience sampling. The psychometric characteristics of the questionnaire were examined through face, content and construct validity respectively. Principal component analysis was performed using varimax rotation in order to check the factorial structure of the questionnaire. The reliability of the questionnaire was checked with the help of Cronbach’s alpha and intra- class correlation (ICC).
Results: The questionnaire’s content validity ratio (CVR) and content validity index (CVI) were 0.91 and 0.86, respectively. In the formal validity check, minor changes were made in the words of most of the items. Based on the results of face validity, some minor changes were made to the vocabulary of most items. The ICC coefficient was more than 0.80 in all dimensions. The results of exploratory and confirmatory factor analysis extracted five factors, autonomy, competence, relatedness, goal setting and goal attainment, and their cumulative variance was %71.48.  The fit of the five-factor model was optimal based on standard goodness of fit indices such as CFI=0.978, GFI=0.930, RMSEA=0.040, CMIN/DF=1.307. Convergent and divergent validity was accepted for all factors. The reliability of the questionnaire was obtained using Cronbach’s alpha test of 0.71.
Conclusion: The five factor structure of the questionnaire of interaction with mobile health technology has good validity and reliability. Therefore, this questionnaire can be used to check the level of interaction of users of medical science students with mobile health technology.

Reza Safdari, Sharare Rostam Niakan Kalhori, Afzal Shamsi, Homa Hajizadegan,
Volume 17, Issue 5 (12-2023)
Abstract

Background and Aim: Atherosclerosis of coronary arteries is the most common heart disease and indication of coronary artery bypass graft(CABG). After CABG, patients need proper self-care and lifestyle changes to increase their quality of life. The present research aimed to the conceptual design of self-care Android software, focusing on the third phase of cardiac rehabilitation.
Materials and Methods: This descriptive research has been carried out in two main phases and a total of six steps in order to assess the informational and functional needs of self-care software and design its conceptual model. After searching in reliable scientific sources and guidelines and checking the available Persian software, through the content validity index questionnaire of Lavshe, Welts and Bassel, 23 people from the medical staff with a history of caring for heart patients participated in the step of determining the requirements and the results were analyzed using SPSS Software. Descriptive analysis was done. Finally, the software model was prepared using integrated modeling language and th mind map was drawn.
Results: Sixty two items were identified in 6 general categories (personal information, medical records, interventions, personal health record, essential information, emergency communication). In the phase of determining the requirements by the experts, 52 items were accepted and 10 items were included in the conceptual model of the application program with minor changes and revisions.
Conclusion: Using mobile health in self-care and cardiac rehabilitation will be a suitable solution in order to increase treatment, follow-up and optimal continuation of self-care in patients. By having different functions, this tool can facilitate lifestyle change and help patients in secondary prevention of cardiovascular events and improve their health.

Azra Daei, Mohammad Reza Soleymani, Hasan Ashrafi-Rizi,
Volume 17, Issue 6 (2-2024)
Abstract

Background and Aim: The role of information in improving the health of society and reducing healthcare costs is undeniable. However, in practice, there exists insufficient and incomplete information among healthcare providers. This lack of comprehensive information among market players leads to inefficiencies and failure in market performance. The main goal of the current research was to investigate health information asymmetry and inadequacy within the health information market.
Materials and Methods: This article is a narrative and unsystematic review. Studies were retrieved from the Scopus, PubMed, Web of Knowledge, Magiran, Sid and Google Scholar databases by using the keywords of information inadequacy, Asymmetry of health information done in the fields of article title, abstract and keywords. Subsequently, according to the purpose of the study, the researchers selected relevant resources and summarized their findings.
Results: 18 paper were selected for this research. In this research, we specifically address health information inadequacies across three key sections: patients, doctors, and insurance. At the end of each section, ways to solve these deficiencies were mentioned. Results Showed patients faced with the phenomenon of injustice in accessing health information, and the continuation of this injustice leads to the poverty of health information, and due to the lack of proper access to health information, the asymmetry of information between the doctor and the patient was created. Doctors, on the other hand, faced challenges in accessing up-to-date and evidence-based information for patient care. Asymmetric information could be exploited, resulting in induced demand. Insurances face the problems of inappropriate selection, moral hazard and demand induction by the supplier or consumer.
Conclusion: Information asymmetry has seriously penetrated the health field and there is a high level of unconfident and uncertainty in it. One of the ways to overcome the health information asymmetry and insufficiency of the health information market is the access of all stakeholders to the information.

Maryam Andalib Kondori, Ahmadreza Varnaseri, Maryam Ghanbari Khoshnood, Seyed Abedin Hoseini Ahangari, Mohammad Karim Saberi, Hamid Bourghi,
Volume 17, Issue 6 (2-2024)
Abstract

Background and Aim: This research aimed to study the status of providing health information services in public libraries in Tehran, which was conducted based on the views of librarians working in these libraries.
Materials and Methods: The research method was applied in terms of its purpose and descriptive in terms of data collection, which was conducted as a survey. The statistical population was 150 librarians of public libraries in Tehran. The tool for collecting information was a researcher-made questionnaire. Data analysis was done using SPSS statistical software..
Results: The status of health information resources available in public libraries of Tehran is low and very low in most sources. The level of familiarity of librarians with health and public health issues is %20. The level of familiarity of librarians with selective dissemination of health information services is low and very low with %77.4. The participation rate of librarians in medical information workshops is faced with the non-participation of %70 of librarians. The familiarity of librarians with the services of selective distribution of health information is low and very low. %60 of librarians are not familiar with medical information systems. The percentage of familiarity of librarians with internal medical websites is %60-78 weak. The percentage of familiarity of librarians with foreign international websites in the field of health is average. Librarians consider the main reason for providing selective health information services to improve the level of health literacy in the society. Also, the main obstacle to providing health information dissemination services is the librarian not having enough time to provide services.
Conclusion: The country’s public libraries should consider measures to familiarize librarians with the field of health information and implement policies in this field. Considering the appropriate technical facilities of public libraries in Tehran, it is possible to create and access internal and external health systems and websites. and expanded the sources and documents of librarians’ health information.

Shahnaz Khademizadeh, Bahram Peymannia, Fatemeh Rafieinasab,
Volume 18, Issue 1 (3-2024)
Abstract

Background and Aim: The term “information behavior,” with an emphasis on health and hygiene, refers to purposeful actions taken to satisfy informational needs related to health. The objective of the current research is to develop and validate a questionnaire on information behavior, with a focus on health and hygiene information.
Materials and Methods: This study was a quantitative research conducted with a tool design approach. Initially, a questionnaire for measuring this behavior was prepared using instrument design methods. The basis for extracting the factors of the present questionnaire has been argumentation and logical repetition. In other words, the researcher, in line with the background of these factors and their repetition in the sources, used them as influential factors in the questionnaire construction. After confirming the content and structural validity, the modified questionnaire was distributed among 238 patients with multiple sclerosis. The sample selection.
was done using the available sampling method. Then, the data were analyzed using exploratory and confirmatory factor analysis. The internal consistency of the data was calculated using Cronbach’s alpha. The collected data were analyzed using descriptive and inferential statistical methods with the help of SPSS and AMOS software.
Results: The content validity of the questionnaire was evaluated with the opinion of 20 experts in information behavior. The reliability of the health information behavior questionnaire was adequate and satisfactory with the overall Cronbach’s alpha coefficient of 0.78 and the Cronbach’s alpha coefficient of the components between 0.71 and 0.94. In order to factor analysis, the sampling adequacy index and the value of Bartlett’s Crowley test were calculated, and all 29 items were statistically significant; which confirms the factorization of the correlation matrix. In the exploratory factor analysis, five factors (avoidance of information), the second factor (need for information), the third factor (exposure to information), the fourth factor (seeking information), and the fifth factor (use of information) were obtained. The indicators of confirmatory factor analysis showed the validity of the proposed structure. The results of the structural equation model test showed that the fit indices were favorable and also indicated the fit of the presented model in the MS patient population.
Conclusion: The obtained results demonstrated that health information behavior in this questionnaire encompasses five factors: information needs, information-seeking behavior, information avoidance, information use, and information confrontation, which were confirmed. The designed scale for assessing health information behavior in the Iranian community has been evaluated and is recommended for use in measuring health information behavior effectively.

Ali Mohammad Mosadeghrad, Mahdiyeh Heydari, Mahya Abbasi, Mahdi Abbasi,
Volume 18, Issue 2 (5-2024)
Abstract

Background and Aim: Health insurance organizations play an important role in increasing people’s access to health services and protecting them financially against catastrophic health costs. Iran Health Insurance Organization (IHIO) is one of the largest public health insurance organizations in Iran, which faces many challenges. The purpose of this research is the strategic analysis of health financing performance of IHIO.
Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data. 
Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO.
Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.

Malihe Ghanaatjoo, Nader Jahanmehr, Dr. Hamed Dehnavi, Aida Samadi,
Volume 18, Issue 2 (5-2024)
Abstract

Background and Aim: The increase in the amount of information and the need for their daily monitoring have led to the development of tools called management dashboards that have the ability to analyze graphical data. In addition to preparing quick reports in different time frames and user-specific format, the dashboard can be useful for providing dynamic updated information for accurate decision-making and quick response to changes.
Materials and Methods: The current research was carried out in the form of qualitative studies and participatory action research method in 9 steps. In this applied and developmental research that was conducted cross-sectionally using the data of the first half of 2022, 11 members of the leadership team of a super-specialized children’s hospital were selected as research participants. The data collection tool was an interview using a questionnaire to determine the importance of indicators and a usability questionnaire (usability) of the dashboard based on three independent variables (usefulness, ease of use and satisfaction). The Excel file of data needed for the dashboard was collected from the HIS system of the hospital, and the dashboard was designed with Power BI software, and the capabilities and access levels of users were determined based on their duties. Data analysis was done using descriptive statistics and Excel software version 2016.
Results: In the stage of determining key performance indicators, out of 39 indicators selected by the research team, 22 indicators scored an average score of 4 or higher (from 5 points) and 21 indicators were able to be implemented. The data repository in Excel format was used as an intermediate environment. The dashboard was displayed on six pages (indicators related to the performance of inpatient beds, mortality, emergency and other indicators) and the capabilities of each page were determined. After implementing the dashboard and determining the access levels of users, obtaining a high score from the questions of the usability questionnaire (5 out of 7 points) and obtaining an average score of 71.8 out of 5 questions related to usefulness variables, 70.5 out of 8 questions related to ease of use. And 71 out of 3 questions related to the satisfaction variable showed that the dashboard designed for the hospital had high usability.
Conclusion: Hospital management dashboard information can be a basis for informed decision-making to achieve benefits such as identifying the best performance, improving performance quality, making faster decisions, reducing errors, improving capacity management and work flow, allocating resources and planning for growth and development. 

Fatemeh Mirshekari, Elham Maserat,
Volume 18, Issue 2 (5-2024)
Abstract

Background and Aim:  Considering the growing trend of cancer in Iran, the development and implementation of digital health literacy systems accelerates the capabilities of digital health and the self-management process of patients. Digital health literacy means the ability to effectively and consciously use digital technologies to access health-related information and services. This skill plays an important role in accessing medical information, disease management, improving the quality of life of people, especially cancer patients. Digital health literacy is considered as one of the most key factors of equal access to digital health information. The purpose of the present study was to formulate the requirements of the digital health literacy system with a focus on cancer.
Materials and Methods: The present study was conducted in two phases of literature review and validity and reliability of requirements in 2023. In the first stage, a literature review was conducted with the keywords of digital health literacy, cancer, requirements, system and application in databases such as PubMed, Scopus, Google Scholar, academic Jihad scientific database and specialized websites. To check the content validity of the survey, 62 experts were surveyed and CVI and CVR were calculated.
Results: Hundered and twenty seven functional and non-functional components were approved. Requirements in the functional section was divided in six main dimensions information literacy module (8 functional components), information and communication technology literacy module (18 functional components), media literacy (5 functional components), public, specialized and population-oriented health literacy module (47 functional components) ), digital health literacy module (28 functional components), and digital health literacy module in cancer (6 functional components) were divided. In the section of digital health literacy in cancer, the main components of needs assessment, digital health literacy training, evaluation and monitoring of the effectiveness of digital interventions and information search skills were approved. Fifteen non-functional components were also approved. Cronbach’s alpha coefficient obtained (92%) indicated high reliability and reproducibility.
Conclusion: Digital health literacy systems can facilitate health care services. Considering the acceptable validity and reliability of the study, the defined requirements can be used to implement digital health literacy systems centered on cancer.

 

Mina Shirvani, Mostafa Roshanzadeh, Maryam Rabiey Faradonbeh, Razieh Mirzaeian,
Volume 18, Issue 2 (5-2024)
Abstract

Background and Aim: Nursing students are exposed to various educational, family, and social stresses and various factors can affect their mental health. Therefore, in order to pay attention to different dimensions of health and investigate the effects of spirituality on health, the present study was conducted to determine the effect of fasting on the mental health of nursing students of Borujen Faculty of Medical Sciences.
Materials and Methods: The present semi-experimental study with a pre-test-post-test design was conducted in 2022 at Shahrekord University of Medical Sciences. Ninety nursing students of Borujen Faculty of Medical Sciences were selected by available methods and assigned to two intervention and control groups by a simple random method. The intervention in this study included at least 23 days of fasting during Ramadan. The data before and after the intervention were collected by the demographic information questionnaire and the 21-question depression, anxiety, and stress standard tool (DASS). The validity and reliability of this questionnaire were conducted for the first time in Iran by Sahebi et al. in 2005. SPSS  was used for analysis. Descriptive statistical tests including frequency percentage, mean and standard deviation, and inferential statistical tests including t-test, paired t-test, analysis of variance, and chi-square were used.
Results: There was no significant difference in the total mental health score between intervention (32.32±11.62) and control (29.87±14.09) groups before the intervention (P=0.08). There was a significant difference in this score between intervention (20.6±5.71) and control (29.49±8.9) groups after the intervention (P=0.04). The total mental health score in the control group before (29.87±14.09) and after (29.49±8.9) the intervention had no significant difference (P=0.15); while in the intervention group before (32.32±11.62) and after (20.6±5.71) the intervention had a significant difference (P=0.001). Mental health dimensions before and after intervention, indicated that anxiety (P=0.04) and stress (P=0.003) decreased significantly after the intervention in the intervention group. However, there was no significant difference in the depression dimension (P=0.06).
Conclusion: According to the results, it should be said that regular and periodic examination of the health level, and the promotion of educational and training programs on the subject of fasting to improve mental health, should be considered.

Hojjat Rahmani, Sadegh Moradi, Nayeb Fadaei Dehcheshmeh,
Volume 18, Issue 4 (10-2024)
Abstract

Background and Aim: The fundamental right and most valuable asset for all strata of society is the enjoyment of health. Individuals residing in nomadic settings face geographical, social, cultural, and linguistic barriers when seeking access to essential services. The provision of healthcare services to nomads has become a complex issue due to the nature of the lifestyle. The aim of this study was to assess the challenges in the provision of healthcare services among the nomads in the Khuzestan province.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.

Taleb Khodaveisi, Hamid Bouraghi, Tooba Mehrabi, Javad Faradmal, Mahdiye Shojaei Baghini, Ali Mohammadpour,
Volume 18, Issue 5 (11-2024)
Abstract

Background and Aim: Identifying the educational needs of health information technology staff is essential before implementing any continuous education programs. This comprehensive study investigates these needs among health information technology personnel working in hospitals in the Hamadan province, considering both the general and specialized aspects of the field.
Materials and Methods: This descriptive cross-sectional study was conducted across 11 hospitals affiliated with Hamadan University of Medical Sciences. The study population comprised staff from the reception, medical records, statistics, and coding departments. Data were gathered using a validated and reliable standardized questionnaire. Collection methods included both in-person and remote approaches. Data analysis was performed using SPSS software, with results reported through descriptive and inferential statistics, specifically utilizing the Kruskal-Wallis test.
Results: The results of this study showed that among the generally accepted needs, items such as information technology (96.7%), legal aspects of medical records (87.6%), and communication skills (76.7%) had the highest percentage. Additionally, educational needs varied across different units: Coding unit staff required more training in the principles of diagnosis documentation (92.9%), familiarity with the coding guidelines for causes of death (85.7%), and familiarity with the coding guidelines for procedures (85.7%), statistics unit staff needed training in statistical software, and reception and medical records staff required education on relevant regulations. There was also a significant correlation between educational needs and certain individual characteristics such as work experience, education level, gender, and field of study.
Conclusion: The study results indicate that designing effective educational programs for health information technology staff requires consideration of individual characteristics, such as gender, work experience, and education level. Additionally, the training should be continuous, tailored to the distinct needs of each group, and delivered at appropriate intervals.

Shabnam Ghasemyani, Kobra Movalled, Shafi Habibi, Rahim Khodayari Zarnaq,
Volume 18, Issue 5 (11-2024)
Abstract

Background and Aim: In recent years, active patient participation in healthcare has been increasingly recognized as a vital component in health policies aimed at achieving optimal health outcomes. This study aims to identify the contexts and areas in which patients engage in safety-related measures within healthcare settings.
Materials and Methods: A scoping review of the English-language literature published from 2000 to 2021 was performed. The search strategy involved relevant keywords, including MeSH modifications, as well as common terms associated with the topic, such as patient collaboration, patient participation, patient engagement, patient involvement, patient education, and patient safety. Literature was sourced from the Scopus, PubMed, Web of Science, and ProQuest databases. The research design adhered to the framework proposed by Arksey and O’Malley, and data analysis was conducted using a content analysis approach.
Results: The search strategy yielded a total of 2,951 articles, of which 38 articles met the inclusion criteria. The majority of studies originated from the United States (14), the United Kingdom (8), and Australia (6). The publication years with the highest output were 2015 (5 articles) and 2017 (4 articles). Five key areas of patient participation were identified: fall prevention, prevention of drug interactions, medical error prevention and awareness, participation in infection control and staff hand hygiene, and educational initiatives. The articles identified focused on various areas, including participation in fall prevention (26.3%), education and awareness promotion, participation in infection control and hand hygiene (23.6%), prevention and awareness of medical errors (18.4%), and prevention of drug interactions (7.9%).The main findings of the reviewed studies were categorized into four areas: patient participation, methods of patient participation, examples and outcomes of patient participation, and challenges associated with patient participation in safety-related measures.
Conclusion: Promoting patient involvement in safety-related practices within healthcare is essential for bolstering patient safety. Such participation is contingent upon empowering patients by improving their health literacy and knowledge while simultaneously fostering a shift in the attitudes of healthcare providers. The involvement of policymakers, particularly at the levels of the Ministry of Health and Medical Education, is critical in advancing patient and family participation in national hospital accreditation standards and facilitating broader initiatives aimed at transitioning the health system towards a model of participatory care.

Maryam Jahanbakhsh, Mahnaz Noroozi, Majid Jangi, Fateme Ghadiri Kofrani,
Volume 18, Issue 5 (11-2024)
Abstract

Background and Aim: Education on sexually transmitted diseases and functional disorders in Iranian women’s society are two important issues that should be addressed as aspects of sexual health. The evidence suggests that mobile phone-based applications can be a suitable tool to improve education in the field of sexual health. Therefore, in the current research, the design of the content model of the mobile phone-based application with an emphasis on diseases transmitted through sexual contact and functional disorders of women has been discussed.
Materials and Methods: The present study is applied-descriptive and was conducted in 3 stages as follows: determining the requirements of the application content model, designing it, and evaluating it. First, information needs were identified and extracted through a civilian review and a review of the App Store, Google Play, and Cafe Bazaar application stores. Then, the results were scientifically organized and reviewed and presented in the form of the application content form to a panel of 7 sexual health experts. The content model was reviewed by the experts and designed through UML diagrams and approved by technical specialists.
Results: The findings of the needs assessment phase consisted of compiling the content requirements of the application in the form of 6 areas: 1- sexual attitude and knowledge 2- improving the quality of sexual life 3- sexually transmitted diseases 4- HIV/AIDS 5- genital infections 6- dysfunction disorders and 41 sub-areas were approved by experts. The compiled model was drawn through the diagrams of the application, sequence, business process and state diagrams and was confirmed and developed during the evaluation with activity diagrams and display screens.
Conclusion: Mobile applications, which are not only more accessible than other technologies, but also provide a space for education, free from any shame and worry due to the one-way nature of the communication, are a suitable platform for increasing Iranian women’s attitudes and knowledge about their sexual health. The designed content model can serve as a Persian, scientific, and native prototype for the development and design of an application that can be implemented on mobile phones to educate women’s sexual health.

Mojtaba Salimi Bani, Mehdi Ghassabi Chorsi, Roghayeh Ershad Sarabi,
Volume 18, Issue 6 (2-2025)
Abstract

Background and Aim: Malaria is one of the health challenges in many countries worldwide. Iran is among the countries that have prioritized a malaria elimination program, aiming to interrupt local transmission of the disease by 2025. Health workeres (community health workers) play an important role in primary healthcare for identifying, controlling, and preventing malaria. Keeping their knowledge and skills up-to-date through continuous training can be effective in the success of this program. Virtual training is a modern educational method that facilitates such training courses. This study aimed to investigate the impact of virtual retraining courses on the knowledge, attitude, and performance of konarak health workers in implementing the malaria elimination program in 2022.
Materials and Methods: This research was a quasi-experimental study with a single-group pre-test and post-test design. The population included 69 individuals who were enrolled using a census method. Initially, a pre-test was conducted to assess the baseline level of knowledge, attitude, and performance of participants regarding malaria elimination strategies. Then, the educational intervention was delivered virtually, followed by a post-test to evaluate the outcomes. The educational content was provided in eight 45-minute sessions by an instructor from the Health worker Training Center using the Sky Room platform. Data collection was performed using a researcher-made questionnaire. Content validity of the questionnaire was confirmed, and its reliability was assessed in a pilot study prior to the training by the responsible expert; the Cronbach’s alpha coefficient of the questionnaire items was calculated at an acceptable level (r=0.83). Data were analyzed using SPSS software and paired t-tests.
Results: Out of 69 participants, 40 (58%) were male and 29 (42%) female. Comparison of pre-test and post-test results showed that the mean scores of knowledge, attitude, and performance of health workeres increased by 1.05, 1.2, and 1.17 units respectively after the training, and these differences were statistically significant (P=0.000).
Conclusion: Based on the results, considering the advantages of virtual training such as easy access, lower cost, and wide coverage, this method is recommended as a strategy for educational programs for healthcare staff.

Ayoub Mohamadian, Ali Moeini, Mahnaz Sanjari, Zahra Abdullahzade,
Volume 18, Issue 6 (2-2025)
Abstract

Background and Aim: Smart health, due to its capacity in disease prevention, is a suitable solution for providing osteoporosis fracture prevention services. Also, the existence of close relationships between active organizations for the prevention of this disease requires this area to be examined from the perspective of the ecosystem. Therefore, the purpose of this study is to identify the factors and players of the ecosystem of preventing fractures caused by osteoporosis in smart health.
Materials and Methods: A qualitative systematic review of meta-synthesis was conducted to find resources related to the prevention of osteoporosis-related fractures. For this purpose, scientific databases of Web of Science, Scopus and PubMed were examined and 155 were selected from 10344 sources found. At the end, by using the Shannon entropy method, the categories of each dimension were ranked.
Results: This systematic review demonstrated that the ecosystem for preventing fractures caused by osteoporosis comprises four main categories of factors: lifestyle (nutrition, exercise, fall prevention, cessation of tobacco, alcohol, and caffeine consumption), clinical (screening, diagnosis, and drug therapy), technological (infrastructure, platform, and application), and contextual (cultural, social participation, policy, economic, and education). The application and infrastructure secured the first and second positions in the ranking, while the platform and education collectively ranked third. Ecosystem participants were also categorized into three core layers: the fracture prevention and treatment team members, firms related to fracture prevention and treatment, and other health stakeholders; the extended layer, which includes affected or at-risk individuals, education stakeholders, cultural stakeholders, social stakeholders, and health stakeholders; and the external layer, comprising international organizations and national ministries. In the ranking, affected or at-risk individuals, other health stakeholders, and fracture prevention and treatment team members earned first to third positions, respectively.
Conclusion: The research results showed that “technological”, “contextual”, “lifestyle change” and “clinical” factors are in the first to fourth places, respectively. Also, among the players, the first place was assigned to the extended layer, the main core took the second place, and the external layer took the third place.

Mohammad Mehdi Sepehri, Minoo Fathi, Nasrin Taherkhani, Roghaye Khasha,
Volume 19, Issue 1 (4-2025)
Abstract

Background and Aim: The development of self-management application for gestational Diabetes based on mobile health, can increase the quality of life of pregnant mothers and reduce the cost of health care and treatment. In order to develop such an application, it is necessary to identify the key players of this system and examine the relationships between them. Then a gestational Diabetes self-management network based on mobile health tools can be presented.
Materials and Methods: The study was conducted in four phases. In the first phase, key players and roles were identified through literature review. In the second phase, interviews with experts were conducted to assess the identified players and their roles. The third phase involved identifying the relationships between players and their roles, accomplished by designing and completing questionnaires that explored the existence or absence of connections between them. In the final phase, the most critical roles and players were determined using social network analysis, employing three centrality indices: degree centrality, betweenness centrality, and closeness centrality.
Results: A total of 22 role players and 17 roles were identified. Based on the results, the Ministry of Health, with a degree centrality index of 41.12, was found to be the most influential and powerful role player in this network. The endocrinologist, nutritionist and obstetrician, with degree centrality indices of 38.52, 36.79, and 31.60. were ranked next. This indicates that the acceptance of this network by the medical community plays a critical role. Additionally, all three centrality indices showed that the role of patient education had the highest values, followed by roles such as education for specialists and healthcare staff, supporting patients in self-care behaviors, and ensuring patient safety and privacy, which were identified as the key roles.
Conclusion: This study aimed to identify various aspects of network design and the influential roles impacting the self-management of gestational Diabetes through mobile health. The Ministry of Health and the National Prevention Committee exhibited the most connections with each other in fulfilling their shared roles. Therefore, the Ministry of Health can fully delegate some roles to the National Prevention. Additionally, recognizing key roles underscores the necessity of prioritizing education and resource allocation for these roles.

Fatemeh Abbasi Ghaletaki, Maryam Kazerani, Azam Shahbodaghi,
Volume 19, Issue 1 (4-2025)
Abstract

Background and Aim: Hospital library services are among the basic infrastructures for promoting e-health readiness. This study evaluated the components of e-health readiness in hospital libraries in Isfahan.
Materials and Methods: This is an applied-descriptive survey. The statistical population is 10 government hospital libraries in Isfahan city. The questionnaire completers are the managers of the aforementioned libraries. The research tool is a researcher-made questionnaire that was prepared by a deep and comprehensive review of related literature. The 61-question questionnaire is based on the Likert scale and has four sections: learning readiness (R1), core readiness (R2), social readiness (R3), and technology readiness (R4). To determine the content validity of the questionnaire, the opinions of professors, specialists, and experts were used and its validity was confirmed. Its reliability was confirmed using Cronbach’s alpha of 0.83. Descriptive statistics were used to examine the data.
Results: Isfahan government hospital libraries are in a good state in terms of learning readiness with a score of 3.77. They were in a moderate state in terms of core readiness with a score of 3.49. Social readiness with a score of 2.47 and technology readiness with a score of 2.48 were reported as poor state. “Literacy level of technology and services related to health care” component with a score of 2.9 from the core readiness, “reimbursement policies” component with a score of 1 from the social readiness, “resources training” component with a score of 1.8 from the learning readiness, and “organization access to ICT education” component with a score of 1.35 from the technology readiness were identified as weak components. In general, all government hospital libraries in Isfahan are in a moderate state in terms of e-health readiness.
Conclusion: Hospital libraries face various challenges in joining the e-health category, including a lack of readiness in the technology sector. The lack of appropriate policies for implementing e-health in libraries, lack of users’ skills in using information and communication technology, users’ ignorance of the e-health services needed in the library, lack of professional human resources, and lack of e-health-related training for users are some of the weaknesses of hospital libraries in the e-health readiness sector.


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